The past 18 months have been a confusing time for employers— particularly when it comes to the Affordable Care Act (ACA). Although many people thought Congress would “repeal and replace” the ACA in 2017, it didn’t happen. Instead, employers have been left scrambling to understand what changes have been made to reshape existing ACA law, especially as it pertains to them.
To help your company cope with the changes and the current state of the ACA, here’s a timeline of what has occurred and what it means for U.S. employers.
January 2017: President Trump Takes Office
February 2017: IRS and Insurance Effects
March 2017: Repeal-and-Replace Bill
The repeal-and-replace bill, formally called the
April 2017: Shifting Tides in the House
As Republicans attempt to get enough votes in the House to advance the repeal-and-replace bill, it becomes clear they don’t have sufficient support to pass it. In an effort to sway Democrats to negotiate, President Trump
May 2017: It’s Essentially Dead
Although the House passes the AHCA, it becomes clear that it has little support in the Senate to move forward. Still, the White House holds a victory celebration and President Trump declares Obama-era care health care law “
June 2017: The Market Responds
Uncertainty about the fate of the ACA and AHCA causes major insurers to
Senate leaders propose a bill called the Better Care Reconciliation Act (BCRA) that would repeal funding for the ACA. Government
July 2017: The McCain Vote
After returning to the Senate from brain surgery, John McCain casts a decisive vote to take up a revised version of the BCRA, called BCRA 2.0. It quickly becomes clear, however, that there are not enough votes. Supporters of the bill try to push a last-ditch “skinny repeal,” or partial repeal, of previous health care law.
In what many considered a surprise move, McCain gives the deciding vote that
August 2017: Attempt at Reconciliation
As major insurers continue to pull out of markets and reduce competition, some Democrat and Republican leaders attempt to come together to create a
Meanwhile the DHHS cuts advertising by almost 90% and announces that it will no longer work with local groups to do new health care enrollments.
September 2017: Last Gasp of Repeal and Replace
Senate supporters of repeal-and-replace efforts announce that they won’t reach the votes needed. At the state and local level, there is widespread confusion about enrollments, waivers, and “reinsurance” reimbursement programs that could help states manage health care costs.
October 2017: Executive Order
President Trump signs an
November 2017: Open Enrollment
Health care enrollment for 2018 opens, shortened to 6 weeks from the previous 12 weeks. There’s debate about whether enrollments are up or down. The Senate addresses the “
December 2017: Tax Bill Promises
The new Tax Cuts and Jobs Act is touted as “essentially” repealing the health law. This is not the case: the
January 2018: Shutdown
News outlets begin reporting that the individual mandate has been
Experts in the insurance and actuarial industries warn that such plans provide insufficient coverage and threaten the stability of the market.
February 2018: Short-Term Insurance
The HHS and President Trump introduce a proposal to allow insurers to sell
March 2018: Final Spending Bill
Despite various promises and insinuations from Senators, the year’s final spending bill passes without so-called ACA stabilization measures. Public confusion about the individual mandate causes experts to
April 2018: New Enrollments Continue
Although opponents view the ACA as dead, enrollments continue, with about
May 2018: Bracing for Change
Citizens brace for
June 2018: On the Back Burner
By June 2018, some health care watchdogs see the debate sitting on the
However, the Trump administration continues to fight ACA protections, asking federal courts to strike down protections for people with preexisting conditions. No changes are predicted to happen quickly, because the issue may go all the way to the Supreme Court.
Where Does This Leave the Employer Mandate?
Although the individual mandate will end in 2019, the employer mandate
This means IRS Letter 226J could still
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